• Jia-jia Dong, Jing-ying Ye, Jun-bo Zhang, Xin Cao, and Jun-long Tan.
• Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Affiliated to Capital University of Medical Science, Beijing 100730, China.
• Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Apr 1; 48 (4): 289-94.

ObjectiveTo compare the different postoperative changes of the pharynx in obstructive sleep apnea hypopnea syndrome (OSAHS) patients treated with H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) surgery or H-UPPP alone.MethodsThe upper airway in 43 patients with OSAHS were scanned during the end of normal respiration before and after treatment. There were 17 patients undergoing H-UPPP alone, 26 patients undergoing H-UPPP combined with PA, with PSG before and after treatment. To compare the efficacy of H-UPPP with PA surgery or H-UPPP alone, upper airway characteristics were measured following each procedure in 43 patients using a quantitative 3-D CT. The 3-D CT measurement were made in lateral and anterior-posterior diameters, cross-section areas and volumes of retropalatal and retroglossal region. The changes in the structure of OSAHS patients treated with H-UPPP combined with PA surgery and H-UPPP alone were compared preoperatively and postoperatively, and the correction features that were presented in AHI and structural changes were analysed.ResultsThe difference between H-UPPP combined with PA (n = 26) and H-UPPP (n = 17) in the changes in apnea hypopnea index (AHI) were (67.5 ± 18.9, 38.7 ± 42.0, t = 2.84, P < 0.05), hard palate lengths were (4.50 ± 3.72) mm and (0.06 ± 0.22) mm (t = 5.55, P < 0.01); anteroposterior diameters of the hard palate level were (3.5 ± 4.3) mm and (-1.7 ± 4.4) mm (t = 3.90, P < 0.01); the minimum anteroposterior diameters of retropalatal were (1.2 ± 2.2) mm and (-1.2 ± 2.3) mm (t = -3.49, P < 0.01); the minimum lateral diameters of retroglossal area were (4.9 ± 9.6) mm and (13.1 ± 9.1) mm (t = 2.80, P < 0.01) preoperatively and postoperatively. The changes in the hard palate lengths were positively correlated to the change in AHI (r = 0.407, P < 0.01), also the change in anteroposterior diameter of the hard palate level (r = 0.351, P < 0.05), the minimum anteroposterior diameter of retropalatal area (r = 0.381, P < 0.01), and the minimum cross-section area of retropalatal (r = 0.312, P < 0.05).ConclusionsH-UPPP combined with PA offers benefit over H-UPPP alone in OSAHS patients, which may be achieved by increased retropalatal airway size. Both the anteroposterior dimensions and the cross-area size are related with the efficacy of surgery.

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